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3 �WTonl aPN: <br /> DRESS OR LOCATION: �ftd <br /> fNER: <br /> ,ATION #: <br /> DEPTH TO FIRST WATER: ft SOIL TYPE: <br /> .MARKS: <br /> LOCATION OF TEST HOLES SHOW WELLS AND STRUCTURES <br /> I I I I I <br /> I I l o <br /> Ilr I I I 'I I I <br /> L <br /> L <br /> IIL PROFILE (IF REQUIRED) <br /> De th Soil T e De th Soil T e De th Soil T De De th Sail T e De th Sail T e <br /> o <br /> .ST HOLE #d'3 DIAMETER: in DEPTH: 38'� S TEST HOLE#2 DIAMETER: In DEPTH: in <br /> NATERNATER REFILLED <br /> -TIMDROP <br /> E READING REFILLED TIME READING DROP <br /> ff <br /> 3, ao' <br /> 3 3• ar; o .3�' y' <br /> 0,-30' c-2, 70 <br /> a9 3a 3 , Y' o •a� �.�3 ' <br /> min/in <br /> PERCOLATION RATE: /in PERCOLATION ROTE: <br /> RECODINIENDED SEPI' AREA: RECONIMENDgE��D//SEPTIC AREA: <br /> Phone: <br /> ST PERFORMED BY: <br /> Phone: Date <br /> TEST CERTIFIED BY: <br /> Phone- �J��7i Date <br /> OBSERVED BY (REH PERC TEST RATE FORMIC <br /> MID 42-01.003 3;0 - Z_4's, — U•32' — .U/* <br /> REVISED 5!72002 <br />